Exercise plan after being sedentary

I’m ashamed to admit the following, so don’t judge me too harshly, as I need some advice. I’ve been fairly sedentary recently (not due to Covid-19), due to Rheumatoid arthritis and anxiety issues, along with a major life change that I’m struggling with (retirement). I started yesterday and walked outside for about 15 minutes and threw a toy for the dog. The walking was in a pasture, so the ground is a little rough, and I could feel it more in my muscles than walking inside (which I’ve been trying to do until the weather gets nicer). My inside walking target is about 30 minutes, but flat hard floors. Last night I had multiple lows and had just put on a new G6 sensor which was doing it’s normal 1st day rodeo, so not any help. Advice on how to get back in better shape (rural so no gym, and no exercise equipment), and how to help prevent these lows, would be very helpful. I’m MDI with Humalog and Lantus, and an A1C of 6.4, and 5’11", 145 lbs. Thanks :blush:

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When was your walk in relation to your last bolus? For me that’s really important, I try not to do anything strenuous within 3 hours of my last bolus… rapid insulin really absorbs fast when your blood gets pumping, and of course digestion resources get redirected into your exertion… so it can be a double edged sword. For me the best time to exercise is late afternoon after lunch has run its course and any bolus is essentially worn off

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You are using a lot of different muscles and tendons in different ways when walking on uneven surfaces compared to inside!

Tell me about your timeline for things like dosage, meals, and exercise times. When do you take Lantus, eat, do all of your stuff?

You can make some simple changes to help with all of this, but the best way is going to depend on how your regimen is setup.

A few general things:
For something like walking, which is a low intensity exercise, you can do it after a meal, and reduce your mealtime bolus, and/or eat a few more carbs than normal. For more intense activities, doing it right after a meal is much more risky with insulin on board. Plus, an intense activity is not ideal with a full stomach.

One of the best general recommendations for exercise is to be devoted to finding time to do it. Just starting with a short time, but being dedicated to it will get you into the routine. And once you have made it a habit, you can gradually add to the duration of it.

If you can come up with a plan of when you want to try to do it, we can work on a good formula for you.

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@Eric thanks for the offer of help!
Due to arthritis, low-intensity is probably my only option, so walking is good. I can do some climbing stairs, but it’s hard because my hips hurt.
I take 13u Lantus before bed, about 10 pm. I’m always low in the morning, my BG drops slowly during the night and continues to drop as I get up and get ready. I take Humalog before breakfast, prebolus about 15-20 minutes. I’m usually low again before lunch (1 pm), and again prebolus Humalog. Dinner, same routine, but later, like 7:30 - 8:00 pm. Exercise in the afternoon would probably be best for me.
I’ve also thought about using 1lb cans from the pantry to develop some more arm strength, something I need.

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The timing is good for an afternoon walk. Taking the Lantus a little earlier might be even better.

Probably unrelated to the exercise topic, but if the amount of Lantus you are taking is good for the daytime, but a little too much at night, you might want to try some slow release extended type of carbs at bedtime.

The Extend bar is one example. You can think of it as a "carb basal ".

If you do this, consider reducing your lunch bolus, and/or adding some carbs to your lunch. Or possibly taking a few carbs right before you start your afternoon walk.

For the carbs before walking, consider these. They have some quick carbs and some slower release carbs that last about 4 hours. These would be good right before walking.

That would be good.

Another thing you can use are wrist weights that attach. That would free up your hands while walking for things like eating a snack, drinking water, or playing fetch with your dog.

Amazon has a bunch of different ones. Here are some that are less expensive than the others.

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@Eric
Awesome! :+1:
Looks like a good plan. I tend to follow the diabetes educator’s instructions too much. She said, “No snacking!” so I don’t snack. Even when it makes sense, like with exercise.
It’s a great plan, and I like the idea of the wrist weights. Thanks!

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Jan, would be cool to see some notes from your experiences, and we can work on fine-tuning it if you would like.

All of these comments need to be taken with context.

More appropriately, she might have meant something like this - “Whenever you have a snack, you might need to make adjustments to your insulin. And taking insulin for a snack or eating a snack can have the potential to raise or drop your blood sugar. So while you are first learning BG management, it might be easier to avoid snacks in general, and just try to stick with the 3 main meals. In general, try to only use snacks for treatments to help you if your blood sugar is falling, or if you need it for exercise. Once you get the basics of dosing figured out, we can work on some tips for dosing for snacks…”

But instead of saying that complicated thing to patients, she simply says “Avoid snacks!”.

That is where our real-world experience makes a difference.

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I agree! These are great suggestions. I sit/stand at the computer a lot of work and I use ankle and wrist weights. Not everyday, but a few times a week, and I do notice the difference after I remove the weights. I do feel improved strength.

I’m very interested in this topic, so I hope you keep us posted on your experiences adding the walking. I, too, have started to add walking and also experience lows!

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